Wednesday, July 1, 2009
Don't forget the underinsured
I've talked a lot in the past about politics and why I believe we need a health care program in this country to guarantee coverage for the uninsured. This recent article reminds us of why we need to also remember the plight of the underinsured.
Apparently, the majority of people who are forced into bankruptcy because of medical bills actually do have health insurance — they just found out the hard way that their policies had all kinds of loopholes that allowed the insurance companies to deny coverage.
The article has a good point — helping the uninsured is important, but we also need to control runaway health care costs and crack down on insurance companies dumping policyholders or denying coverage.
Apparently, the majority of people who are forced into bankruptcy because of medical bills actually do have health insurance — they just found out the hard way that their policies had all kinds of loopholes that allowed the insurance companies to deny coverage.
The article has a good point — helping the uninsured is important, but we also need to control runaway health care costs and crack down on insurance companies dumping policyholders or denying coverage.
Labels: politics
Diabetes and hard (physical) work
Today I spent about six hours working at the barn. As a type 1 diabetic, this is something I really have to be careful about, because the exercise makes my blood sugar drop.
I've been more active lately, so I've been having to tinker with my insulin doses a little. Usually when I become more active, my Lantus needs dip for a short while, then come back up and settle back where they were before. I think this is because the exercise changes my metabolism, which changes how my body processes sugar.
The other thing I have to make sure of is that I run my blood sugar a bit high before I go out to the barn. If my blood sugar is on the low or normal side, I'll eat a snack; if I'm eating a meal, I'll take a little less insulin than I normally would.
I also try to always bring my glucagon kit with me when I'm doing something that could make me crash. I didn't today, but I should have. For example, if I go for a bike ride I stick it in my handlebar bag.
It's important to remember that activities such as moving furniture — or, in my case, mucking manure and moving mulch at the barn — are just as active as going to the gym and working out, and therefore can have just as much of an effect on your blood sugar.
I've been more active lately, so I've been having to tinker with my insulin doses a little. Usually when I become more active, my Lantus needs dip for a short while, then come back up and settle back where they were before. I think this is because the exercise changes my metabolism, which changes how my body processes sugar.
The other thing I have to make sure of is that I run my blood sugar a bit high before I go out to the barn. If my blood sugar is on the low or normal side, I'll eat a snack; if I'm eating a meal, I'll take a little less insulin than I normally would.
I also try to always bring my glucagon kit with me when I'm doing something that could make me crash. I didn't today, but I should have. For example, if I go for a bike ride I stick it in my handlebar bag.
It's important to remember that activities such as moving furniture — or, in my case, mucking manure and moving mulch at the barn — are just as active as going to the gym and working out, and therefore can have just as much of an effect on your blood sugar.
Labels: diabetes and exercise
Friday, June 19, 2009
Will it pass?
The Obama health care reform situation is ongoing, and though I don't read every single article that comes out on the subject, I am waiting anxiously to find out what will happen.
A new article reports a step in the right direction:
I especially like the part where it says the plan will "end insurance company practices that deny coverage to the sick." That is a BIG deal to me, since health insurance companies can and do refuse to cover a diabetic under an individual plan.
The article also talks about whether the program is something we can afford to implement. Me personally, this is one piece of legislation that I'd be quite happy to pay higher taxes for. Heck yeah, I'll pay higher taxes in order to make sure I can always get health insurance!
A new article reports a step in the right direction:
Trying to regain momentum on a core issue of Barack Obama's presidency, House Democrats on Friday unveiled legislation they said would cover virtually all the nearly 50 million uninsured Americans. Major provisions of the draft bill would impose new responsibilities on individuals and employers to get coverage, end insurance company practices that deny coverage to the sick and create a new government-sponsored plan to compete with private companies.
I especially like the part where it says the plan will "end insurance company practices that deny coverage to the sick." That is a BIG deal to me, since health insurance companies can and do refuse to cover a diabetic under an individual plan.
The article also talks about whether the program is something we can afford to implement. Me personally, this is one piece of legislation that I'd be quite happy to pay higher taxes for. Heck yeah, I'll pay higher taxes in order to make sure I can always get health insurance!
Labels: politics
Thursday, June 11, 2009
President Obama's health care reform
Lately there have been many headlines about President Obama's plans for health care reform. I admittedly haven't been following it very closely, but I've been noting the headlines. I'm glad he is pursuing this issue already, as I think it is very important for our nation's future that we rein in health care expenses and provide insurance to those who can't afford it.
There are a couple of important points that Obama is making that I personally support wholeheartedly.
And the other:
I think these are the elements to a strong health care system that protects all of our nation's citizens: allowing those who can keep their own plans, and to assist those who can't. Certainly, if I can afford to get a plan that provides me better coverage, there's no reason why I should be denied that. But if I can't afford health care, there's also no reason why I should die simply because I was unlucky enough to be born with the genes for a potentially lethal autoimmune disease.
There are a couple of important points that Obama is making that I personally support wholeheartedly.
The president promised that with his health care overhaul "if you like your doctor you'll be able to keep your doctor, if you like your health care plan, you'll be able to keep your health care plan."
"We're not going to make you change," he said.
And the other:
"Every plan should include an affordable, basic benefits package," he said. "And if you can't afford one of these we should give you assistance."
I think these are the elements to a strong health care system that protects all of our nation's citizens: allowing those who can keep their own plans, and to assist those who can't. Certainly, if I can afford to get a plan that provides me better coverage, there's no reason why I should be denied that. But if I can't afford health care, there's also no reason why I should die simply because I was unlucky enough to be born with the genes for a potentially lethal autoimmune disease.
Labels: politics
Monday, June 1, 2009
Self-treatment requires flexibility
As a type 1 diabetic, a lot of your treatment is actually in your own hands. YOU are the one who lives with your diabetes, so technically you are more qualified to make small, daily adjustments in your insulin regimen than your doctor.
For example, since my doctor's appointment on Friday I've been pushing lows. Actually, it technically started last week, and I dropped my Lantus dose a bit then. Now I've had to drop it again.
My point is, as a type 1 diabetic you have to be able to recognize when your insulin regimen needs to be changed. You are the one checking your blood sugar every day, so you are the one who is most likely to notice trends in the numbers. And if you are constantly crashing or constantly going high, you are the one who will need to make a decision about your insulin doses. You can't wait until the next time you see the doctor, particularly if you are dealing with a lot of lows.
I'm happy to say that so far, my adjusted Lantus dose seems to be doing the trick. I didn't have any major lows or major highs today. It remains to be seen whether I'll be staying on this dose long-term or not — it's 2 units lower than what I take 99 percent of the time, and drops like this one are usually pretty temporary. But when my insulin needs go up again, I'll be watching for the signs!
For example, since my doctor's appointment on Friday I've been pushing lows. Actually, it technically started last week, and I dropped my Lantus dose a bit then. Now I've had to drop it again.
My point is, as a type 1 diabetic you have to be able to recognize when your insulin regimen needs to be changed. You are the one checking your blood sugar every day, so you are the one who is most likely to notice trends in the numbers. And if you are constantly crashing or constantly going high, you are the one who will need to make a decision about your insulin doses. You can't wait until the next time you see the doctor, particularly if you are dealing with a lot of lows.
I'm happy to say that so far, my adjusted Lantus dose seems to be doing the trick. I didn't have any major lows or major highs today. It remains to be seen whether I'll be staying on this dose long-term or not — it's 2 units lower than what I take 99 percent of the time, and drops like this one are usually pretty temporary. But when my insulin needs go up again, I'll be watching for the signs!
Friday, May 29, 2009
An appointment with my endocrinologist
This morning I had an appointment with my endocrinologist. (As a type 1 diabetic, I have to see the doctor every three months, or four times a year.)
You might remember me being really concerned earlier this year because my A1c was 7.9. I was having some trouble with my blood sugar at that time, primarily because my nightly Lantus was wrong and because I had gotten out of the habit of checking my blood sugar often enough.
I requested that I be allowed to schedule my next doctor's appointment for 6 weeks out instead of 3 months. By the time I went in for my follow-up appointment, my A1c had dropped to 7.2.
This time it was exactly the same — 7.2 — but my doctor seemed pleased. I've been in there weekly lately for a study I am participating in, and I've had to do a ton of documentation for the study, so right now my doctor actually knows all of the intimate details of how I manage my diabetes. As a result, today's visit was fairly brief.
The one thing my doctor did suggest is that I use a different insulin-to-carb ratio at dinnertime. I take my Lantus dose in the evening, and on top of that I tend to eat big dinners (which I think tends to create some temporary insulin resistance or something), so my blood sugars have a nasty habit of popping up in the late evenings. To try to correct this, I'm going to start trying a 1 to 10 ratio at dinnertime, rather than the 1 to 15 I use the rest of the time.
Perhaps if the new dinnertime ratio does its job, I can get my A1c back down below 7 for my next visit!
You might remember me being really concerned earlier this year because my A1c was 7.9. I was having some trouble with my blood sugar at that time, primarily because my nightly Lantus was wrong and because I had gotten out of the habit of checking my blood sugar often enough.
I requested that I be allowed to schedule my next doctor's appointment for 6 weeks out instead of 3 months. By the time I went in for my follow-up appointment, my A1c had dropped to 7.2.
This time it was exactly the same — 7.2 — but my doctor seemed pleased. I've been in there weekly lately for a study I am participating in, and I've had to do a ton of documentation for the study, so right now my doctor actually knows all of the intimate details of how I manage my diabetes. As a result, today's visit was fairly brief.
The one thing my doctor did suggest is that I use a different insulin-to-carb ratio at dinnertime. I take my Lantus dose in the evening, and on top of that I tend to eat big dinners (which I think tends to create some temporary insulin resistance or something), so my blood sugars have a nasty habit of popping up in the late evenings. To try to correct this, I'm going to start trying a 1 to 10 ratio at dinnertime, rather than the 1 to 15 I use the rest of the time.
Perhaps if the new dinnertime ratio does its job, I can get my A1c back down below 7 for my next visit!
Labels: doctor's appointments
Update
I almost forgot to post my update on the case where the 13-year-old boy and his mom were refusing medical treatment. I no longer have the link, but I saw a day or so later that they had returned to town and were accepting chemo. Crisis averted.
The article also noted that the boy's chances of survival with chemo were 90 percent, but only 5 percent without chemo. You'll remember (I hope) that I only agreed with his and his mom's actions if there wasn't going to be much difference in his chances if he went through the chemo; I don't see why anyone should be forced to go through a painful treatment if it's not very likely to help. Clearly, though, this was not the case here — so yeah, refusing chemo when it makes him 18 times more likely to live is pretty neglectful of a parent.
I still am somewhat uncomfortable with the government intervening in cases where the treatment has dubious benefits, though.
The article also noted that the boy's chances of survival with chemo were 90 percent, but only 5 percent without chemo. You'll remember (I hope) that I only agreed with his and his mom's actions if there wasn't going to be much difference in his chances if he went through the chemo; I don't see why anyone should be forced to go through a painful treatment if it's not very likely to help. Clearly, though, this was not the case here — so yeah, refusing chemo when it makes him 18 times more likely to live is pretty neglectful of a parent.
I still am somewhat uncomfortable with the government intervening in cases where the treatment has dubious benefits, though.
Labels: miscellaneous
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